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calcium chloride

B05XA07

Forms & Strengths

Injection: 10% solution (100 mg/mL) in 10 mL vials and syringes

Adult Dosing

Hypocalcemia, severe: 500 mg to 1 g (5 to 10 mL of 10% solution) IV slowly, repeated as needed based on serum calcium levels
Cardiopulmonary resuscitation (hyperkalemia, hypocalcemia, calcium channel blocker toxicity): 500 mg to 1 g (5 to 10 mL of 10% solution) IV push, may repeat in 10 minutes

Pediatric Dosing

Hypocalcemia, severe / Resuscitation: 20 mg/kg (0.2 mL/kg of 10% solution) IV/IO slowly, maximum single dose 1 g (10 mL), may repeat in 10 minutes

Indications

Treatment of severe hypocalcemia requiring rapid increase in serum calcium levels
Adjunct in the treatment of cardiac arrest due to hyperkalemia, hypocalcemia, or calcium channel blocker toxicity

Mechanism of Action

Replenishes calcium ions, which are essential for the functional integrity of nervous, muscular, and skeletal systems, maintenance of normal heart function, and blood coagulation

Contraindications

Ventricular fibrillation during cardiac resuscitation
Hypercalcemia
Calcium renal calculi
Routine use in cardiac resuscitation with normal calcium levels

Adverse Reactions

Vasodilation, decreased blood pressure, syncope, bradycardia, cardiac arrhythmias, cardiac arrest (with rapid IV administration)
Severe tissue necrosis, sloughing, and calcification upon extravasation
Local burning, pain, and venous thrombosis at injection site
Chalky taste, hot flashes, or sense of oppression with rapid infusion

Drug Interactions

Digitalis glycosides: Concomitant IV calcium increases risk of severe cardiac arrhythmias and toxicity
Thiazide diuretics: May cause hypercalcemia due to decreased renal calcium excretion
Ceftriaxone: Precipitation can occur in neonates when mixed with calcium-containing IV solutions
Calcium channel blockers: May antagonize the therapeutic effects of calcium

Curated Content: Needs Vetting Before Put to Clinical Use